| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $190.67 | $190.67 | $190.67 | |
Aetna
| Professional | $190.67 | $383.69 | $589.91 | |
Cigna
| Professional | $40.57 | $40.57 | $40.57 | |
Moda Health
| Facility | $51.40 | $262.24 | $589.91 | |
Molina
| Professional | $30.87 | $51.40 | $416.82 | |
United
| Professional | $23.53 | $27.73 | $276.36 |